Comparing mortality rates in COVID patients requiring tracheostomy vs non-COVID patients requiring tracheostomy
N. Zamith*a (Dr), S. Islama (Dr), R. Becharaa (Dr)
a Medical College of Georgia - Augusta University, Augusta, Ga, UNITED STATES
* nzamith@augusta.edu
Introduction:
Tracheostomy is a frequently performed procedure in mechanically ventilated patients requiring prolonged respiratory support. Prior to the COVID-19 pandemic, studies describe benefits that include improved patient comfort, decreased nursing burden, decrease in sedation requirements, faster weaning from mechanical ventilation, lower risk of ventilator associated pneumonia, and lower mortality, just to name a few. During the COVID-19 pandemic, there was a dramatic increase in the need for prolonged mechanical ventilation. The mortality of COVID-19 patients requiring tracheostomy is yet to be elucidated. In this retrospective trial, we compare the mortality in COVID and non-COVID patients requiring tracheostomy due to prolonged respiratory support.
Patients and Methods:
In this retrospective trial, we reviewed charts of all tracheostomies performed at our institution between October 2018 and February 2022. Overall mortality at 7 days, 14 days, 21 days, and 30-day following tracheostomy was assessed in 74 COVID patients and 97 non-COVID patients.
Results:
COVID-19 patients were found to have a statistically significant higher 14-day mortality rate (p=0.001), 21 days (p=0.002), and 30-day mortality (p=0.002) when compared to non-COVID patients. COVID patient mortality rates were 12% at 7 days, 32% at 14 days, 36% at 21 days, and 38% at 30 days. For non-COVID patients, mortality rates were 5% at 7 days, 11% at 14 days, 15% at 21 days, and 16% at 30 days.
Conclusion:
We showed that COVID-19 patients requiring tracheostomy have a higher mortality rates when compared to non-COVID patients. Additional co-morbidities may also play a role, an analysis which we are pursuing. We suggest that benefit of prolonged ventilatory support in patients with COVID should be assessed and discussed prior to performing tracheostomy.
Disclosure of funding source(s): none